Despite many rural and remote initiatives over recent years, the health needs of many Australian communities are still not adequately met. Residents of rural and remote communities continue to show poorer health outcomes than residents in metropolitan centres, while the health of Indigenous communities remains unacceptable. Many rural and remote communities experience ongoing difficulties in recruiting and retaining an appropriate and adequately trained medical and health workforce, while residents face increasing difficulties in accessing appropriate care in situations where integration and continuity of care are woefully inadequate. Health authorities and funding remains oriented to treatment and curative care services, while many of the upstream determinants of Indigenous, rural and remote health are poorly addressed.